FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 331:10-15 July 7, 1994 Number 1 Next

	Full Text Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Fibroadenomas are benign breast tumors that are commonly diagnosed in young women and are associated with a slight increase in the risk of breast cancer. These lesions vary considerably in their histologic characteristics. We assessed the correlation between the histologic features of fibroadenomas and the risk of subsequent breast cancer.

Methods We conducted a retrospective cohort study of a consecutive series of patients with fibroadenoma diagnosed between 1950 and 1968. Follow-up data were obtained for 1835 patients (90 percent of those eligible). Fibroadenomas with cysts, sclerosing adenosis, epithelial calcifications, or papillary apocrine changes were classified as complex. The rate of subsequent breast cancer among the patients was compared with the rates in two control groups, women listed in the Connecticut Tumor Registry and women chosen from among the patients' sisters-in-law.

Results The risk of invasive breast cancer was 2.17 times higher among the patients with fibroadenoma than among the controls (95 percent confidence interval, 1.5 to 3.2). The relative risk increased to 3.10 among patients with complex fibroadenomas (95 percent confidence interval, 1.9 to 5.1) and remained elevated for decades after diagnosis. Patients with benign proliferative disease in the parenchyma adjacent to the fibroadenoma had a relative risk of 3.88 (95 percent confidence interval, 2.1 to 7.3). Patients with a family history of breast cancer in whom complex fibroadenoma was diagnosed had a relative risk of 3.72, as compared with controls with a family history (95 percent confidence interval, 1.4 to 10). Two thirds of the patients had noncomplex fibroadenomas and no family history of breast cancer and did not have an increased risk.

Conclusions Fibroadenoma is a long-term risk factor for breast cancer. The risk is increased in women with complex fibroadenomas, proliferative disease, or a family history of breast cancer.

Source Information

From the Departments of Preventive Medicine (W.D.D., W.D.P., M.S.R., P.A.S.) and Pathology (D.L.P., F.F.P., C.L.V.-J.), Vanderbilt University School of Medicine, Nashville.

Address reprint requests to Dr. Dupont at Vanderbilt University School of Medicine, Department of Preventive Medicine, A-1124 Medical Center N., Nashville, TN 37232-2637.

Full Text of this Article

This article has been cited by other articles:

• Vade, A., Lafita, V. S., Ward, K. A., Lim-Dunham, J. E., Bova, D. (2008). Role of Breast Sonography in Imaging of Adolescents with Palpable Solid Breast Masses. Am. J. Roentgenol. 191: 659-663 [Abstract] [Full Text]  
• Sklair-Levy, M., Sella, T., Alweiss, T., Craciun, I., Libson, E., Mally, B. (2008). Incidence and Management of Complex Fibroadenomas. Am. J. Roentgenol. 190: 214-218 [Abstract] [Full Text]  
• Wells, C A, El-Ayat, G A (2007). Non-operative breast pathology: apocrine lesions. J. Clin. Pathol. 60: 1313-1320 [Abstract] [Full Text]  
• Ashbeck, E. L., Rosenberg, R. D., Stauber, P. M., Key, C. R. (2007). Benign Breast Biopsy Diagnosis and Subsequent Risk of Breast Cancer. Cancer Epidemiol. Biomarkers Prev. 16: 467-472 [Abstract] [Full Text]  
• Hartmann, L. C., Sellers, T. A., Frost, M. H., Lingle, W. L., Degnim, A. C., Ghosh, K., Vierkant, R. A., Maloney, S. D., Pankratz, V. S., Hillman, D. W., Suman, V. J., Johnson, J., Blake, C., Tlsty, T., Vachon, C. M., Melton, L. J. III, Visscher, D. W. (2005). Benign Breast Disease and the Risk of Breast Cancer. NEJM 353: 229-237 [Abstract] [Full Text]  
• Saglam, A, Can, B (2005). Coexistence of lactating adenoma and invasive ductal adenocarcinoma of the breast in a pregnant woman. J. Clin. Pathol. 58: 87-89 [Abstract] [Full Text]  
• Gill, H. K., Ioffe, O. B., Berg, W. A. (2003). When Is a Diagnosis of Sclerosing Adenosis Acceptable at Core Biopsy?. Radiology 228: 50-57 [Abstract] [Full Text]  
• Franco, N., Arnould, L., Mege, F., Picard, S.-F., Arveux, P., Lizard-Nacol, S. (2003). Comparative Analysis of Molecular Alterations in Fibroadenomas Associated or Not With Breast Cancer. Arch Surg 138: 291-295 [Abstract] [Full Text]  
• Vogel, V. G., Costantino, J. P., Wickerham, D. L., Cronin, W. M. (2003). National Surgical Adjuvant Breast and Bowel Project Update: Prevention Trials and Endocrine Therapy of Ductal Carcinoma in Situ. Clin. Cancer Res. 9: 495S-501S [Abstract] [Full Text]  
• Kuijper, A, Preisler-Adams, S S, Rahusen, F D, Gille, J J P, van der Wall, E, van Diest, P J (2002). Multiple fibroadenomas harbouring carcinoma in situ in a woman with a family history of breast/ovarian cancer. J. Clin. Pathol. 55: 795-797 [Abstract] [Full Text]  
• Shoker, B S, Jarvis, C, Clarke, R B, Anderson, E, Munro, C, Davies, M P A, Sibson, D R, Sloane, J P (2000). Abnormal regulation of the oestrogen receptor in benign breast lesions. J. Clin. Pathol. 53: 778-783 [Abstract] [Full Text]  
• Delfino, R. J., Sinha, R., Smith, C., West, J., White, E., Lin, H. J., Liao, S.-Y., Gim, J. S.Y., Ma, H. L., Butler, J., Anton-Culver, H. (2000). Breast cancer, heterocyclic aromatic amines from meat and N-acetyltransferase 2 genotype. Carcinogenesis 21: 607-615 [Abstract] [Full Text]  
• Tibiletti, M. G., Sessa, F., Bernasconi, B., Cerutti, R., Broggi, B., Furlan, D., Acquati, F., Bianchi, M., Russo, A., Capella, C., Taramelli, R. (2000). A Large 6q Deletion Is a Common Cytogenetic Alteration in Fibroadenomas, Pre-malignant Lesions, and Carcinomas of the Breast. Clin. Cancer Res. 6: 1422-1431 [Abstract] [Full Text]  
• Gobbi, H., Dupont, W. D., Simpson, J. F., Plummer, W.D. Jr., Schuyler, P. A., Olson, S. J., Arteaga, C. L., Page, D. L. (1999). Transforming Growth Factor-{beta} and Breast Cancer Risk in Women With Mammary Epithelial Hyperplasia. JNCI J Natl Cancer Inst 91: 2096-2101 [Abstract] [Full Text]  
• Barton, M. B., Harris, R., Fletcher, S. W. (1999). Does This Patient Have Breast Cancer?: The Screening Clinical Breast Examination: Should It Be Done? How?. JAMA 282: 1270-1280 [Abstract] [Full Text]  
• Cyrlak, D., Pahl, M., Carpenter, S. E. (1999). Breast Imaging Case of the Day. RadioGraphics 19: 549-551 [Full Text]  
• Jacobs, T. W., Byrne, C., Colditz, G., Connolly, J. L., Schnitt, S. J. (1999). Radial Scars in Benign Breast-Biopsy Specimens and the Risk of Breast Cancer. NEJM 340: 430-436 [Abstract] [Full Text]  
• (1994). DOES FIBROADENOMA CONFER A HIGHER BREAST-CANCER RISK?. JWatch General 1994: 1-1 [Full Text]